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10-07-2023 | Multiple Sclerosis | Review

Clinical efficacy and safety of melatonin supplementation in multiple sclerosis: a systematic review

Authors: Soroush Morsali, Zahra Sabahi, Javad Kakaei, Zahra Hakimzadeh, Sana Hamidi, Elnaz Gholipour-khalili, Sarvin Sanaie, Mahnaz Talebi, Amirreza Naseri

Published in: Inflammopharmacology | Issue 5/2023

Abstract

Background

Melatonin is a neurohormone secreted predominantly by the pineal gland that is demonstrated to be associated with the pathogenesis of multiple sclerosis (MS). This research desires to evaluate the tolerability and beneficial effects of exogenous melatonin supplementations in patients with MS.

Methods

This study was executed following the PRISMA 2020 statement. Both observational and interventional studies which reported the clinical effectiveness and/or safety of melatonin supplementation in patients with MS were included in this systematic review. Ovid, PubMed, Scopus, Embase, and Web of Science databases were searched and the risk of bias in included studies was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools based on study design.

Results

Out of 1304 results of database searches, finally, 14 articles, including 7 randomized controlled trials (RCTs), 6 case–control studies, and one quasi-experimental study, were included based on the full-text review. Included phenotypes of MS were mostly relapsing-remitting MS (RRMS) (in 11 studies); it was secondary progressive MS (SPMS) in only one study, and two other studies had a mixture of the different phenotypes. The course of treatment with melatonin supplementation was between 2 weeks and 12 months. There were no substantial safety issues. Although melatonin was associated with enhanced oxidative stress and inflammation status, concerning the clinical benefits, limited studies suggested improvements in sleep conditions, cognitive outcomes, and fatigue in MS.

Discussion

There are insufficient data to support the regular melatonin prescription in MS. Limitations such as the small number of included studies, the diversity of the dosage, route, and duration of melatonin administration, and the diversity of assessment tests lead to unconvincing findings in this study. There is a need for future studies to achieve a comprehensive judgment on this subject.

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Title: Clinical efficacy and safety of melatonin supplementation in multiple sclerosis: a systematic review
Authors: Soroush Morsali
Zahra Sabahi
Javad Kakaei
Zahra Hakimzadeh
Sana Hamidi
Elnaz Gholipour-khalili
Sarvin Sanaie
Mahnaz Talebi
Amirreza Naseri
Publication date: 10-07-2023
Publisher: Springer International Publishing
Keyword: Multiple Sclerosis
Published in: Inflammopharmacology / Issue 5/2023
Print ISSN: 0925-4692
Electronic ISSN: 1568-5608
DOI: https://doi.org/10.1007/s10787-023-01271-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Clinical efficacy and safety of melatonin supplementation in multiple sclerosis: a systematic review

Abstract

Background

Methods

Results

Discussion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Discussion

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